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1. se1:-ex_ lanatcr•J. <br />?lace the n� "e c= the el'_;; ile cover^ e. ta-. -agency <br />a <br />2. Project=:c-ser - <br />race ,- f- nzncial assistance. <br />3, R�c•�e :T::. er - Each =ec•.;est s cu <br />1' to numbered stair':i.^.7 w'_t -he <br />s.. <br />.u..:^er one (1). If t: --i is the last billing, specify •�-:al". <br />• <br />Pay to - ?lace the name of the ?ro4e•ct Sponsor exactly as it wishes <br />�. <br />the Stat- harrant to be made paya:.le. <br />3. Req. -'est. ?ericd Covered - Note t: a dates of the -period f_o:n w:e last <br />request to t::e current request. Expenses incurred aca=.^st the <br />Cu:I.I e..nt request must :all' wit:='! this Period. <br />6. -toms in this section are to he displayed in two (2) main categories . <br />as shown ,=_a col=n headings: <br />a. Self=explanatory. <br />b. Self-eYalanatcry. <br />C. ':Otals - when totaling under "Total Obligations to Date"- <br />1.:cl de a--ount in current request. <br />d. This will depend upon the hype of prof ect--user-or_a:ited <br />resource-based (2/3) , ce:.vinatien (1/3) . The state funds <br />requested must rot exceed these rat'_os. <br />If the total required local share is to be c=_%i;ted in <br />cash to project construction, these ratios must be adhered <br />to <br />with each rei=, =seu,ent request. I` all or part of the <br />local snare is to be committed in land value (purc:ase or <br />i a <br />donation) these :'atlas do not apply. However, State funds <br />w-111 be released only for project costs incurred tp to <br />the amount of documented expenditures for items 6. a or h. <br />7-3. DNR OFF:E r USE CNii <br />9. Self -explanatory - <br />The signature space below the double lines is for the Cepar`=e^_t <br />of 'at al Resources use. <br />5 JUL..1a41992 <br />